Outcome of Linac-based stereotactic radiosurgery for arteriovenous malformation: the St. Luke’s Medical Center experience, 2003-2008

Frances Lily Lantin-Penano, Miriam Joy Calaguas, Manuel Mariano, Peter Rivera. MD, Emmanuel Enrique Magalona. MD, Lilian Rodriguez. MSc

Background: Complete surgical excision of cerebral arteriovenous malformations (AVM) eliminates any future risk of hemorrhage and is curative. However, patient selection and location of AVMs play an important role in reducing mortality and morbidity. Stereotactic radiotherapy is considered to be an effective alternative method of treatment of intracranial arteriovenous malformations (AVM) when microsurgical resection is contraindicated because of AVM location or poor patient condition. This study aims to describe the clinical and radiologic outcomes of patients with AVM who underwent LINAC-based stereotactic radiosurgery (SRS) at a tertiary hospital.

Methods: This is a descriptive study involving AVM patients who underwent SRS at St. Luke’s Medical Center from 2003-2008. Medical records were reviewed and relevant data were compiled and described.

Results: A total of 38 patients with AVMs who underwent SRS with adequate follow-up were included. The mean nidus volume among patients was 6.56 cc. The mean prescribed maximum dose given was 23 Gy.  At a median follow-up of 64.34 months, obliteration rate of AVMs treated with SRS is 69.70%.

Conclusion: All patients in this analyzed cohort have shown a good response in terms of obliteration, tolerance and favorable toxicity profile.  When compared to the published outcome of other centers in the use of SRS for AVM, our results are similar.